Linkage of Diabetic Retinopathy with Blood Antioxidants and Gut Microbiota in Type Two Diabetes Mellitus Saudi Patients

Abstract

Background: The retina is a light-sensitive nerve layer located at the back of the eye that creates images of objects. These cells kept alive by getting oxygen and nutrients from tiny blood vessels in the eye. Retinopathy is a disease of the retina that is more prevalent in type 2 diabetes mellitus patients. Diabetic retinopathy is a leading cause of blindness because hyperglycemia weakens retinal capillaries, resulting in leakage of blood into the surrounding space. This bleeding can result in formation of scar tissue, which can cause traction retinal detachment and maculopathy. The development of a panel of blood biomarkers to monitor diabetic retinopathies is essential for both diagnosis and prognosis. Proteomics as a powerful tool for the analysis of complex mixtures of proteins and the identification of biomarkers can be of great importance. Purpose: To detect early nerve fiber layer changes around macula and optic disc in diabetic patients and to correlate diabetic retinopathy with blood antioxidants and gut microbiota in T2DM in Saudi patients. Materials and Methods: In this cross-sectional case-control study, a total of 77 eyes of 39 subjects aged 40-60 years who did not have any history of eye injuries or eye diseases affecting fundus viewing, were recruited from King Saud University Campus and the department of ophthalmology in King Abdul Aziz university hospital in Riyadh. All subjects underwent full ophthalmic examination including Peripapillary retinal nerve fiber layer thickness and macular profile, Proteomic approach of collected overnight fasting plasma and Microbial stool examination. Results: The nerve fiber layer thickness around the optic disc was measured for all groups and there was no statistically significant difference in all quadrants between groups. The total retinal thickness at the macular area was different among all groups and tends to increase in group 3 due to diabetic retinopathy. The macular thickness in the 4 quadrants revealed no statistical difference except in the inferior quadrant. Glutathione S transferase and lipid peroxides showed no significant difference between the three studied groups; vitamin C and Glutathione were surprisingly higher in controlled diabetic patients relative to controls. Moreover, over growth of bacteroids participated to the evolution of retinopathy in diabetic patients. Conclusion: As hyperglycemia and oxidative stress are implicated in the pathogenesis of diabetic retinopathy, the present study certified that the progressive damage can be delayed in controlled type 2 diabetic patients using different treatment modalities that subside oxidative stress.